World journal of surgery
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World journal of surgery · Jul 2009
Comparative StudyBenefits versus risks: a prospective audit. Feeding jejunostomy during esophagectomy.
The purpose of this prospectively collected database is to evaluate the safety, efficacy, and utility of postoperative jejunostomy feeding in terms of achieving nutritional goals and evaluating gastrointestinal and mechanical complications in patients undergoing esophagectomy. ⋯ Tube jejunostomy feeding is an effective method for providing nutritional support in patients undergoing esophagectomy, and it allows home support for the subset who fail to thrive. Prolonged tube feeding was continued in patients developing anastomotic disruptions and postoperative complications. Feeding jejunostomy has a definitive role to play in the management of the patients undergoing esophagectomy.
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World journal of surgery · Jul 2009
Randomized Controlled Trial Multicenter Study Comparative StudyImpact of general versus local anesthesia on early postoperative cognitive dysfunction following carotid endarterectomy: GALA Study Subgroup Analysis.
The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. ⋯ We concluded that performing local anesthesia in patients undergoing CEA positively influenced early postoperative neurocognitive outcomes. Significant group differences in postoperative S100beta concentrations confirmed the beneficial effect of local anesthesia.
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World journal of surgery · Jul 2009
ReviewOvercoming distance: video-conferencing as a clinical and educational tool among surgeons.
Since the 1960s, there has been substantial development in the uses of video-conferencing (VC) among medical personnel, including surgeons who have adopted the technology. ⋯ VC is a common clinical tool for surgeons and provides a great opportunity to alter surgical practice and to offer patients the best expertise in surgical treatment despite long distances, especially in rural areas.
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World journal of surgery · Jul 2009
Comparative StudyTotal pelvic exenteration for primary and recurrent malignancies.
Complete resection is the most important prognostic factor in surgery for pelvic tumors. In locally advanced and recurrent pelvic malignancies, radical margins are sometimes difficult to obtain because of close relation to or growth in adjacent organs/structures. Total pelvic exenteration (TPE) is an exenterative operation for these advanced tumors and involves en bloc resection of the rectum, bladder, and internal genital organs (prostate/seminal vesicles or uterus, ovaries and/or vagina). ⋯ Total pelvic exenteration is accompanied with considerable morbidity, but good local control and acceptable overall survival justifies the use of this extensive surgical technique in most patients, especially patients with primary locally advanced rectal cancer and recurrent cervical cancer.